Endocrinology and Metabolism

Case Reports

A Case of Pituitary Metastasis of Breast Cancer Presenting as Diabetes Insipidus and Panhypopituitarism.: Jae Wuk Kwak, Byung Soo Jie, Sun Hwa Hong, Ji Hyun Kim, Seung Hwan Lee, Jae Hyung Jo, Hyuk Sang Kwon, Kun Ho Youn, Bong Yun Cha, Ho Young Son; J Korean Endocr Soc. 2007;22(2):125-129. Published online April 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.2.125

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Metastasis to the pituitary gland from systemic cancer is a rare condition. The breast and lung are the most common sites of primary tumor metastasis. Pituitary metastasis may present with diabetes insipidus, cranial nerve palsy and hypopituitarism, and diabetes insipidus is the most frequent symptom at presentation. We report here on a 44 year-old woman with pituitary metastasis from breast cancer, and she developed central diabetes insipidus and hypopituitarism. The clinical diagnosis was made by performing a water deprivation test, a combined pituitary test and a MRI brain scan, and the latter showed metastatic tumor in the pituitary gland with invasion of the pituitary stalk. Symptomatic relief was obtained with administration of desmopressin; the urine osmolarity was increased with this treatment. We report here on a case of pituitary metastasis from breast cancer and the patient developed central diabetes insipidus and hypopituitarism. We also include a review of the relevant literature.

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A Case of Pituitary Metastasis from Breast Cancer That Presented as Left Visual Disturbance
Young Ha Kim, Beom jun Lee, Kyung Jin Lee, Jin Hee Cho
Journal of Korean Neurosurgical Society.2012; 51(2): 94. CrossRef
A Case of Panhypopituitarism and Central Diabetes Insipidus Caused by Primary Central Nervous System Lymphoma
Mi Sun Ahn, Soon Sun Kim, Tae Ho Kim, Seung Jin Han, Dae Jung Kim, Hugh Chul Kim, Se Hyuk Kim, Jae Ho Han, Ho Sung Kim, Yoon-Sok Chung
Journal of Korean Endocrine Society.2008; 23(4): 260. CrossRef

A Case of Pituitary Metastasis of Lung Presenting as Diabetes Insipidus.: Hong Seung Kim, Choon Hee Chung, Mee Yeon Cho, Yun Mi Kim, Kye Chul Shin, Do Hoon Kim, Kwang Sun Song; J Korean Endocr Soc. 1997;12(4):602-608. Published online January 1, 2001

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Abstract PDF: This is a case report of a 61 years old man with suprasellar and pituitary metastasis from bronchogenic adenocarcinoma who developed polyuria and polydipsia. The clinical diagnosis has been made by bronchoscopy with washing cytology, biopsy of cervical lymph node, and brain MRI scan. Brain MRI scan showed metastatic tumor in the suprasellar area and pituitary gland with invasion of pituitary stalk. Light microscopic findings revealed adenocarcinoma in bronchoscopic washing cytology, and metastatic adenocarcinoma in the cervical lymph node. The combined pituitary stimulation test showed decreased reserve capacity of anterior pituitary hormones. And the water deprivation test also showed complete central diabetes inspidus. We report a case of suprasellar and pituitary metastasis from bronchogenic adenocarcinoma with a review of the literature.

A Case of Central Diabetes Insipidus Caused by Metastatin Malignant Lymphoma.: Sung Kil Lim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Hyun Soo Kim, Kyung Rae Kim, Yoo Mi Lee, Yong Suk Yoon, Suk Ho Kwon, Jae Hyun Nam, Sang Hak Lee; J Korean Endocr Soc. 1997;12(4):596-601. Published online January 1, 2001

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Abstract PDF: The causes of central diabetes insipidus (CDI) are numerous; some primary cases are idiopathic while most secondary cases are surgically induced or the result of tumor. The frequency of metastatic tumor as a cause of DI is 6% to 20% of cases, Variety of malignancies including breast, lung, colon, prostate cancer, and leukemia/lymphoma have been reported to metastasize to the pituitary, although most patients are asymptomatic. Clinical manifestations of pituitary metastases include anterior pituitary failure, visual disturbance, and extraocular muscle weakness. DI is the most common clinical manifestation of hypothalamic-pituitary axis (HPA) metastases. Anatomical basis far this clinical picture is that most metastases occur in the posterior lobe. We report on a 35-year-old male patient with meningeal involvement of malignant lymphoma that was thought to be associated with DI. Confirmation of primary malignancy was made by biopsy at site of cervical lymph node and tonsil, Pituitary involvement was suspected on brain MRI, and satisfactory symptornatic relief was obtained with vasopressin. Because of the progres-sion of underlying lymphorna that has shown no response to combined anticancer chemotherapy, the patient expired on 60th hospital day.

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